Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.48 / $87.10 / $316.23	Facility		$52.48	$87.10	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.12 / $30.90 / $57.54	Professional		$25.12	$30.90	$57.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $79.43 / $100.00	Facility		$39.81	$79.43	$100.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $40.74 / $54.95	Professional		$20.42	$40.74	$54.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Professional		$75.86	$75.86	$75.86
Pacific Source Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $38.90 / $57.54	Facility		$38.90	$38.90	$57.54
Premera BCBS Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $67.61 / $114.82	Facility		$38.90	$67.61	$114.82
Premera BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $34.67 / $46.77	Professional		$34.67	$34.67	$46.77
Regence BlueShield Facility/Professional Facility Modifier Low / Median / High Price $40.74 / $57.54 / $102.33	Facility		$40.74	$57.54	$102.33
Regence BlueShield Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $34.67 / $38.90	Professional		$28.84	$34.67	$38.90
United Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $46.77 / $46.77	Facility		$38.90	$46.77	$46.77
United Facility/Professional Professional Modifier Low / Median / High Price $16.22 / $16.22 / $38.90	Professional		$16.22	$16.22	$38.90
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $17.38 / $17.38 / $69.18	Professional		$17.38	$17.38	$69.18